title: Perforation of the colon by invading recurrent gastrointestinal stromal tumors during sunitinib treatment.
abstract: The molecular targets of sunitinib are receptor tyrosine kinases (RTKs), and this drug has also been known to exert blocking effects on the activation of KIT, which is similar to the mechanism of action of imatinib. Moreover, sunitinib has an additional anti-angiogenic effect through its inhibition of the vascular endothelial growth factor receptor activation. We report here a 70-year-old patient diagnosed with a recurrent gastrointestinal stromal tumor (GIST), which invaded the transverse colon and led to a perforation during sunitinib treatment. A computed tomography scan and 3-dimensional reconstruction showed necrosis of the recurrent hepatic mass and perforation of the invaded transverse colon. After percutaneous drainage of the intraperitoneal abscess, antibiotic treatment and restricted diet, the condition of the patient improved. The present case is the first to report that sunitinib, which is administered to treat GIST resistant to imatinib, can cause unexpected colon perforation and subsequent peritonitis.
authors.affiliation: Department of Surgery, College of Medicine, the Catholic University of Korea, Seoul 150-713, South Korea.
authors.forename: Hoon
authors.initials: H
authors.lastname: Hur
authors.forename: Ae-Ryoung
authors.initials: AR
authors.lastname: Park
authors.forename: Sung-Bae
authors.initials: SB
authors.lastname: Jee
authors.forename: Seung-Eun
authors.initials: SE
authors.lastname: Jung
authors.forename: Wook
authors.initials: W
authors.lastname: Kim
authors.forename: Hae-Myung
authors.initials: HM
authors.lastname: Jeon
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D001549:Benzamides; D019008:Drug Resistance, Neoplasm; D046152:Gastrointestinal Stromal Tumors / Q000188:drug therapy*; D006801:Humans; D000068877:Imatinib Mesylate; D007211:Indoles / Q000009:adverse effects* / Q000627:therapeutic use*; D007416:Intestinal Perforation / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D010538:Peritonitis / Q000209:etiology; D010879:Piperazines / Q000627:therapeutic use; D011743:Pyrimidines / Q000627:therapeutic use; D011758:Pyrroles / Q000009:adverse effects* / Q000627:therapeutic use*; D000077210:Sunitinib
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D007211:Indoles; D010879:Piperazines; D011743:Pyrimidines; D011758:Pyrroles; D000068877:Imatinib Mesylate; D000077210:Sunitinib